Safety Limit Warning Levels for the Avoidance of Excessive Sound Amplification to Protect Against Further Hearing Loss

Objective: To determine safe output sound pressure levels (SPL) for sound amplification devices to preserve hearing sensitivity after usage. Design: A mathematical model consisting of the Modified Power Law (MPL) (Humes & Jesteadt, 1991) combined with equations for predicting temporary threshold shift (TTS) and subsequent permanent threshold shift (PTS) (Macrae, 1994b) was used to determine safe output SPL. Study sample: The study involves no new human subject measurements of loudness tolerance or threshold shifts. PTS was determined by the MPL model for 234 audiograms and the SPL output recommended by four different validated prescription recommendations for hearing aids. Results: PTS can, on rare occasion, occur as a result of SPL delivered by hearing aids at modern day prescription recommendations. The trading relationship of safe output SPL, decibel hearing level (dB HL) threshold, and PTS was captured with algebraic expressions. Better hearing thresholds lowered the safe output SPL and higher thresholds raised the safe output SPL. Conclusion: Safe output SPL can consider the magnitude of unaided hearing loss. For devices not set to prescriptive levels, limiting the output SPL below the safe levels identified should protect against threshold worsening as a result of long-term usage